Outpatient methotrexate treatment strategies for unruptured tubal ectopic pregnancy

Aim: To evaluate the selection criteria for outpatient treatment of unruptured ectopic pregnancy. Methods: A total of 124 unruptured ectopic pregnancies that had been treated with single-dose intramuscular methotrexate injections during the period from 2012 to 2017 at Duzce UniversityFaculty of Medicine, Training and Research Hospital were evaluated. Results: Success rate of the medical treatment with single dose methotraxate was 76.61% (n = 95) of 124 patient. The mean duration of hospital stay was shorter in successful medical treatment group (p=0.030). Combining β-hCG level at the first day of methotrexate treatment with size of ectopic focus and/or the presence of fluid in the abdomen significantly increased the sensitivity, specificity and positive predictivity for successfully treated with methotrexate (sensitivity = 70.3%, specificity =86.3%, positive predictive value =80%). Conclusions: We can choose patients that will be good responder to methotrexate treatment of ectopic pregnancy without hospitalization by initial serum β-hCG values, size of ectopic focus and the presence of fluid in the abdomen